[Unwanted side effects of antibacterials--a diagnostic challenge].
[Unwanted side effects of antibacterials--a diagnostic challenge].
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DOI：
10.1055/s-0028-1082824
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Gleiter, C H
中科院分区：
文献类型：
--
作者：
Fux, R;Morike, K;Gleiter, C H
我们提出了三例罕见的副作用，似乎是由于抗菌药物治疗。一名57岁女性患者因呼吸困难加重而入院。计算机断层扫描显示间质性肺纤维化，这是由于呋喃妥因（50mg /d）的毒性作用，患者使用了大约一年的复发性尿路感染。她在入院两周后因急性呼吸衰竭死亡。一名20岁男性患者，表现为最剧烈的头痛和精神运动减速。假性脑瘤，这被怀疑是潜在的原因，被描述为一个罕见的副作用米诺环素，病人服用痤疮脓疱（100毫克单剂量）。停用米诺环素后，神经症状迅速消退。82岁女性患者使用莫西沙星（400mg /d）治疗发热性支气管肺感染1周。在治疗期间，出现精神错乱和严重痴呆，并在停药后持续两个多月。痴呆综合征似乎可能与氟喹诺酮类药物的使用有关。总之，不属于主治医师领域的药物不良反应尤其难以识别。最重要的是，开处方的医生必须考虑到罕见的副作用。
We present three cases of rare side effects which appeared to be attributable to antibacterial drug treatment. A 57-year-old female patient was admitted to hospital due to increasing dyspnea. Computed tomography revealed interstitial lung fibrosis which was attributed to the toxic effects of nitrofurantoin (50 mg/d) that the patient used for approximately one year for recurrent urinary tract infection. She died two weeks after hospital admission due to acute respiratory failure. A 20-year-old male patient presented with most intense headache and psychomotor deceleration. Pseudotumor cerebri, which was suspected to be the underlying cause, is described as a rare side effect of minocyclin which the patient has taken for acne pustulosa (100 mg single dose). After dechallenge of minocyclin, neurological symptoms quickly subsided. A 82-year-old female patient used moxifloxacin (400 mg/d) for febrile bronchopulmonary infection for one week. During this therapy, confusion and severe dementia presented and remained for more than two months after discontinuation. The demential syndrome appears to be possibly related to the fluoroquinolone use. In summary, adverse drug effects not pertaining to the primary physician's field are especially difficult to identify. Most importantly, rare side effects must be borne in mind by the prescribing physician.